Hypocomplementemia correlates with intrauterine growth retardation in systemic lupus erythematosus

PROBLEM: The aim of this study was to elucidate fetomaternal risks in syste mic lupus erythematosus (SLE)-complicated pregnancy. METHOD OF STUDY: Pregnancy course, complications, and fetal outcome in 82 p regnancies of 55 patients with SLE were investigated. RESULTS: These 82 pregnancies resulted in 14 fetal losses and 66 live birth s. Without clinical manifestation of SLE-flare, 4 of 8 patients who had low serum complement activity during the pregnancies delivered small-for-date neonates. The rate of the intrauterine growth retardation was significantly higher than that observed in pregnancies with normal complement activity. The frequency of premature deliveries (60%) in patients who received more t han 15 mg/day of prednisolone was significantly high when compared with pre gnancies maintained by 0-15 mg/day (13.1%). CONCLUSIONS: These data demonstrate the preconceptional and perinatal manag ement necessary in SLE and suggest that the pregnancy with hypocomplementem ia, the disease activity, and/or a relatively high maintenance dose of cort icosteroid should be carefully managed and monitored.